For many Baltimore City residents, accessing dental care is a journey fraught with prohibitive co-pays, lack of coverage, and difficulty finding practices accepting new patients. Outside of a social services center on North Broadway, a bus converted into a full-service dental office is helping to address the lack of access to dental treatment for Baltimore’s low-income residents.
“They don’t know where to go, there are no facilities for them,” Director Jesus Vasallo said of the 15-20 customers the Dental Mobile Unit sees per day. “We see people here who have not been to the dentist in years.”
While data from the Maryland Behavioral Risk Factor Surveillance System indicates that, in 2012, the last year for which figures are available, 72.7 percent of adults reported seeing a dentist in the last year, for adults making under $25,000 per year, that percentage dropped to 58.4. Among adults lacking any type of medical insurance, the percentage was 49.2.
Dr. Harry Goodman, director of Maryland’s Office of Oral Health, said that while these figures come from scientifically sampled adults interviewed by trained personnel, the actual percentages are likely lower since these polls rely on self-reported data.
Because Medicare does not cover dental treatment, and since Medicaid had not required states to provide adult dental coverage as part of the program until recently, state-by-state data on how regularly adults access dental care is limited.
The data that does exist, while providing the information on access cited above, does not tell us what, if any, out of pocket costs may have been incurred for that access.
Licole Shird, a patient on the Dental Mobile Unit, spoke about the challenges of accessing dental care as a Medicaid recipient. “The problem is, a lot of them you have co-pays, and a lot of times you don’t have the money to pay for that co-pay,” said Shird, adding, “Or a lot of dentists won’t accept the insurance that you have.”
Megan Stevenson, a patient and a Medicaid recipient, said she had had difficulty obtaining treatment in the past. She said it was because her insurance was not accepted, or she could not afford to pay the $125 co-pay. Stevenson, 23, had not seen a dentist since she was 17 and needs two root canals.
John Lopez, manager of the Dental Mobile Unit, said another reason many of their patients have been unable to access dental treatment is that there are not many offices in the area accepting new patients.
Among the services offered by the mobile service are cleanings, general preventive care, root canals, and even some extractions. Whether procedures like root canals and extractions are performed on the bus is at the discretion of the doctors onboard. Those whose conditions require a visit to an oral surgeon are given referrals, often to the University of Maryland School of Dentistry.
The Dental Mobile Unit operates from Monday to Thursday next to the social services office located at 2000 North Broadway. They accept Medicaid, see both children and adults, and do not charge co-pays.
